If you had to pick just one, what's the worst Medicare-related decision someone can make?

Question

Brian Moore · Accepted Answer

In my professional opinion, the worst Medicare-related decision is choosing a plan without assessing one’s individual circumstances and relying instead on unsolicited advice from others. I frequently encounter clients who select coverage based on someone else’s experience, only to discover it doesn’t align with their specific healthcare or financial needs. This misstep often leads to unnecessary complications or expenses that a tailored evaluation could prevent.

Answered by Brian Moore on March 26, 2025

Broker Licensed in OH

Answered by Brian Moore Medicare Insurance Agent

Larry Dalton · Answer

People fail to analyze their options at the beginning of their Medicare journey, making hasty decisions or following their friends' or families' decisions. These first decisions could affect their Medicare coverage throughout their retirement years, especially their pocketbooks. You should know all the facts or have an agent that you can trust to guide you through the Medicare process when signing up for Medicare.

Answered by Larry Dalton on March 29, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Lt Col Tim Brown · Answer

The worst thing is not doing anything. Runner up is procrastination. Medicare doesn’t have to be hard. With a good agent you can get the government speak out of the way and get your arms around it.

Answered by Lt Col Tim Brown on June 14, 2025

Broker Licensed in TN, AL, CO & 10 other states

Answered by Lt Col Tim Brown Medicare Insurance Agent

Gary Church · Answer

Your doctors are not in network. Your prescription is not in the formulary with that Medicare Advantage plan. It is essential to review your plan each Annual Enrollment Period (AEP).

Melonie Wood · Answer

The worst mistake, which I see often is incorrect information. Fraud agents telling members they can get $3000 for food/ Not meeting with someone in person to learn what Medicare is, what Medicare can do for someone, review plans in your zip code, understand , compare the plans & make the best choice for you.

Answered by Melonie Wood on March 30, 2025

Agent Licensed in FL & AL

Answered by Melonie Wood Medicare Insurance Agent

David Bell · Answer

Worst mistake? Not taking Part B when you have no other coverage. Even if you "don't think you need it now" or "the premium is expensive," it will cost you more later. There is a penalty charged for the rest of your life for every month you go without if you decide to get it later. You will also have to wait to get it until the enrollment period and they don't cover back claims, so if something happens, it is 100% your responsibility. 

Please note, if you have coverage from work, you won't need Part B until you loose coverage from work and you're not penalized for that time.

James Carlson · Answer

Making a decision without real good understanding of their options.  If they choose a Advantage plan, they may not ever be able to apply for a Medicare Supplement Plan.

David Silver · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/if-you-had-to-pick-just-one-whats-the-worst-medicare-related-decision-someone-can-make#david-silver

Ray McCauley · Answer

Choosing a plan without understanding all the rules. Doing so can prevent you from having options of changing later

Christopher Palazzini · Answer

Enrolling into an application via mail or picking a program their friend recommends. Everyone's Medicare is different. Doctors, Medications, networks and out of pockets all play a heavy role.

Phillip Lovelady · Answer

Procrastination. Many people wait until the last minute to get their "Medicare affairs," in order. 

The worst Medicare-related decision someone can make is missing the Initial Enrollment Period (IEP) for Part B without a valid excuse. The IEP is that seven-month window around your 65th birthday (three months before, the month of, and three after). Skip it, and you’re not just delaying coverage—you’re harming yourself long-term. Unless you’re covered by a qualifying employer plan, you’ll face a late enrollment penalty: a 10% hike on your Part B premium for every 12-month period you could’ve enrolled but didn’t. That sticks with you for life.

Patrick Hecht · Answer

The worst decision someone can make is assuming they don't need to enroll, especially in Part B or Part D, because they're healthy or not using it yet. Delaying enrollment without qualifying coverage can lead to lifelong penalties and gaps in coverage when you least expect it. I've seen people hit with hefty late-enrollment penalties or denied certain services simply because they didn't have the right plan in place. Medicare is not something you want to just "wing it" on. The safest choice is to get informed early, understand the rules, and work with someone who can guide you through it.

Answered by Patrick Hecht on May 21, 2025

Broker Licensed in VA, CA, MD, PA & WV

Answered by Patrick Hecht Medicare Insurance Agent

Jon Kelderman · Answer

Not choosing a plan and just signing up with original Medicare. At minimum sign up for a $0 premium Medicare Advantage plan. Your maximum out of pocket would usually be less than $5000 in Iowa. Parts A and B only you have an unlimited maximum.

Answered by Jon Kelderman on June 24, 2025

Broker Licensed in IA, AZ & TX

Answered by Jon Kelderman Medicare Insurance Agent

James Romeo · Answer

Delaying or choosing to not get enrolled when they become eligible and during your set enrollment periods.  
Not enrolling in Medicare Part A & Part B when they are first eligible can results in delays and penalties. 
Not choosing additional coverage through Medicare Supplements or Medicare Advantage or Drug coverage plans when you are first eligible.  The results can be penalties, delay or denial of coverages, and the penalties can last the rest of your life.  The enrollment timing of Medicare and is very important that you enroll in your election periods.
I have had to have hard conversations with people when they miss these deadlines and there is nothing we can do and getting bad advise from the internet, people who are just older then you falls into that as well.  Internet people and people in your sphere of influence their needs and experiences may not be yours.  I have made the comment that just because someone is educated in there field does not automatically mean they are experts in everything.  Example is that I may not bring car to a CPA to fix the transmission being a CPA means they are in an expert in there field and highly educated does automatically make you and expert.  So think about whatever in your past your working life and if you were going to teach me you are an expert in that.  Just like that we are experts in Medicare and do this every day and we can help guide you.  Let us know and we can help avoid penalties and delays and regrets!

Steven Bleicher · Answer

THE absolutely worst decision someone new to Medicare can make is if you have previously qualified for Medicaid and are now close to becoming Medicare-eligible and you are not aware of a “SNP” aka, (Special Needs Plan) Advantage plan. The reason is that everything is totally free! Free hospitalizations, free doctor and specialist visits, free prescription drugs, free in-home care, free dental, vision and hearing products/treatments and more! The only apparent problem is that it CAN depend on the county that you live in. How can you beat that??

Answered by Steven Bleicher on May 15, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Gregg Matheny · Answer

I think one of the worst decisions that can be made when it comes to Medicare It’s to just decide not to be covered at all. Not being covered by an employer plan, And not having Medicare part B Does prevent you from having to pay a Medicare part B premium every month. However, If in the future, you ever decide that you need some kind of Medicare plan then at that point there will be a fairly large penalty associated with part B as well as part D. I’m not a fan of paying a monthly cost for something I don’t need, But I do usually see this decision come back and really hurt people. My role as a broker is really only to educate/enroll and I can’t force anybody to make a good choice or a bad choice.

Answered by Gregg Matheny on March 25, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

Barbara Barnes, CMIP® · Answer

In my opinion, the worst decision that someone can make is to ignore Medicare completely. Some people do not understand how Medicare works or what their benefits could be, and therefore choose not to do anything. There is a specific window of time when you turn 65 or when you leave your employer’s insurance when you may sign up for Medicare. Ignoring that period of time and doing nothing will mean that you are uninsured and have to wait to get Medicare until the following year. You will also be penalized if you do not have other creditable coverage while you are waiting for your Medicare benefits to begin. If you are over 65 and not receiving health insurance from your active employment or your spouse’s active employment, Medicare is almost certainly the best option for your health insurance needs.

Answered by Barbara Barnes, CMIP® on May 24, 2025

Agent Licensed in PA

Answered by Barbara Barnes, CMIP® Medicare Insurance Agent

Rick Boyd · Answer

Stay with standard Medicare A, and not enrolling into Medicare part B, and a part D medication plan.

Leslie Kaz · Answer

The worst Medicare-related decision is not enrolling in Medicare Part B when first eligible, without having creditable coverage from an employer or spouse’s plan. This can lead to lifelong premium penalties (10% per year delayed) and gaps in coverage, leaving you vulnerable to high medical costs. Always confirm eligibility and coverage options with Medicare or a trusted advisor to avoid this costly mistake.

Answered by Leslie Kaz on May 6, 2025

Agent Licensed in CA, AL, AZ & 7 other states

Answered by Leslie Kaz Medicare Insurance Agent

George Kolitsas · Answer

Getting the same plan as your friend, because they like it. Medicare is not a one plan fits all, a plan that works well for one person might now work well for another.

Sandra Kerley · Answer

The worst Medicare related decision anyone can make would be not working with a professional. When working with a professional licensed Medicare agent - make sure they look at all of your options for all carriers in your area. Make sure they educate you on how the plan they recommend for you will fit all of your current and pslossible future needs. And make sure they are very direct in all of your benefits.

Answered by Sandra Kerley on April 12, 2025

Broker Licensed in SC, NC, OH, VA & VT

Answered by Sandra Kerley Medicare Insurance Agent

Ginger Gibbs · Answer

To not enroll in Part B when they qualify for it. Also to not enroll in a PDP plan when they qualify for part D.   This can be very expensive

Fred Manas · Answer

The worst Medicare-related decision is likely to choosing a plan that doesn't adequately cover your healthcare needs, especially if you have chronic conditions or require specific specialists or medications. This can lead to unnecessary out-of-pocket expenses, delayed or denied care, and potential health problems. 
Here's why this is such a significant mistake:
Limited Provider Networks:
Medicare Advantage plans often limit your choices to in-network providers, which can be problematic if you need to see a specific specialist or prefer a particular doctor who isn't part of the plan's network. 
Higher Out-of-Pocket Costs:
Choosing a plan that doesn't align with your needs can lead to higher co-pays, deductibles, and coinsurance payments, potentially straining your budget. 
Delayed or Denied Care:
Some plans require prior authorization for certain procedures or medications, which can delay treatment or lead to denial if the plan doesn't deem the care medically necessary. 
Inadequate Prescription Drug Coverage:
If your plan's formulary (list of covered drugs) doesn't include the medications you need, you could face high costs or have to switch plans. 
Lack of Flexibility:
Once you enroll in a plan, switching can be difficult or only possible during specific enrollment periods, leaving you potentially locked into a plan that doesn't meet your needs. 
Medicare vs. Medicare Advantage: The Choices Can Be ...
Therefore, carefully evaluating your individual healthcare needs and comparing various Medicare plan options is crucial to make an informed decision and avoid this potentially detrimental mistake.

William Scott · Answer

Deciding not to get a prescription drug plan when they become eligible for one based on the fact they've never taken a prescription drug in the past and therefore believe they'll never have to in the future.

Answered by William Scott on May 27, 2025

Broker Licensed in GA, CO, NC, OH, SC & TX

Answered by William Scott Medicare Insurance Agent

Kris Neupauer · Answer

This is a great question. The easiest and straightforward answer is never try to figure out Medicare, Medicare supplement or advantage plans on your own. You need an agent or a broker.

Alexander Lehn · Answer

One of the worst Medicare-related decisions someone could make is to choose their coverage completely on their own or through a captive agent. The guidance and help from an independent broker is free to Seniors and does not cost them anything beyond the regular premiums they would already be paying. Brokers are compensated evenly by the insurance companies so they are not beholden to pressure folks into a plan that doesn't suit their needs. Brokers can analyze finances, health, needs, geography, and more to help make sure the choice for coverage fits each client on an individual basis without sacrificing something essential that a captive agent or individual would not even realize was a factor.

Many people try to figure it out on their own and end up incurring penalties or delays/gaps in coverage. They can also get contacted by tele-sales teams that don't understand local markets which can leave them vulnerable or without guidance due to the nature of health networks and the other intricacies of Medicare coverage.

At the end of the day, seek professional and honest help. It doesn't cost a dime and you'll be in the best position for your future if you do.

Mark Mabaquiao · Answer

In my experience, one of the most unfortunate and costly decisions individuals make is choosing not to enroll in a Medicare Part D prescription drug plan—often because they weren’t taking any medications at the time. I’ve had a handful of conversations with individuals who reach out mid-year, after being diagnosed with a serious condition, only to realize they now need expensive, life-saving medications. Unfortunately, because they opted out of coverage, they’re left facing two major challenges: the financial burden of paying out-of-pocket for essential prescriptions and the emotional and physical toll of managing their health while waiting for the next Medicare enrollment period.

Answered by Mark Mabaquiao on May 29, 2025

Broker Licensed in NV, AZ, CA, FL, HI & IL

Answered by Mark Mabaquiao Medicare Insurance Agent

Nina Besant · Answer

Thinking they can do it themselves. The same way you would hire a licensed Plumber, Electrician, car mechanic, etc is the same way you should approach medicare decisions.

Bobby Coates · Answer

Having an on going Medical condition and choosing to go with a Medicare Advantage Plan. Having Medicare as primary and a Medigap plan will significantly reduce your cost for ongoing treatment.

William Murray · Answer

The one worst decision which came 1st to my mind is for someone to decide not to enroll in Medicare Prescription Drug coverage because they don't take any prescriptions on a regular routine maintenance basis and don't see any reason, at this time, why they would use the coverage.

Answered by William Murray on May 5, 2025

Broker Licensed in CA, AZ, CO & 31 other states

Answered by William Murray Medicare Insurance Agent

Ramiro Garcia · Answer

In my personal opinion, a mistake would be enrolling in a Medicare Plan and your Doctor isn't in network. Always cosult with your Dr before enrollng.
God Bless

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If you had to pick just one, what's the worst Medicare-related decision someone can make?

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